Our skin consists of multiple layers. The lowermost layers produce new cells to maintain a constant state of turnover of the skin cells. Normally it takes around a month for the cells from the basal layer to move upwards, reach the topmost layer and thereafter shed off. In Psoriasis this rate of renewal is drastically increased. Therefore there is an increased rate of formation and shedding of cells which is visible as whitish flakes on affected skin.

Generally, sunlight is beneficial in psoriasis. Alcohol and smoking can worsen psoriasis. Also a few medicines can exacerbate the disease. No studies have till date established any relationship between diet and psoriasis.

Psoriasis generally presents with itchy areas which feel rough and dry to touch. The usual affected areas are scalp, elbows, shins, palms and soles. Various factors can influence the severity of psoriasis. It may be a mild disease with just one or two areas involved or it could be very severe and involve a significant area. Psoriasis can also involve the nails. The appearance of the skin may lead to social concerns and thus affects an individual’s quality of life.

No. A complete cure for Psoriasis does not exist. However, various treatment options to control the signs and symptoms are available. The treatment can eventually lead to a normal appearing skin. However, even after complete clearance post-treatment, there is always a possibility of relapse.

In case of mild psoriasis the treatment mainly comprises of creams, lotions and ointments.

Emollients/ Moisturisers: These help to combat the dryness and itching. Topical steroids: Steroid creams/ointments are required to control the disease. These are generally combined with salicylic acid to increase their penetration through the thick skin. Their long term use however needs to be monitored by a dermatologist.Tar: Tar creams or ointments have been in use for a long time and definitely are beneficial.Other medications: Calcipotriol, Calcitriol, Tazarotene, Tacrolimus and Pimecrolimus can be preferred in different case scenarios.Shampoos: A medicated tar based shampoo may be used along with to a steroid and salicylic acid based scalp lotion.

2. Oral medication

There are various medicines which can be used in case of severe disease or psoriasis not responding to other therapies. These have to be taken under the supervision of a Dermatologist. Constant monitoring is required in most cases. Methotrexate, Acitrtin, Cyclosporine etc are a few oral medicines which can be prescribed.

The risks and benefits of these therapies are discussed in detail during consultation.

UVA and UVB are the two types of Ultraviolet Therapies available for treatment of Psoriasis. These are useful in cases of extensive disease. Topical creams can be continued along with phototherapy. The therapy is done in clinic 2-3 times a week.

The current addition to the available therapies are Biologics (Etanercept, Infliximab etc). These therapies act on a molecular level to achieve quick control of the disease. They achieve faster control of the disease and also near complete clearance.